A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?
Encouraging the child to take deep breaths hourly
Maintaining fluids through an intravenous line
Beginning active range-of-motion exercises
Seeing that the child ingests a protein-rich diet
The Correct Answer is B
A. Encouraging deep breathing is important for preventing pulmonary complications but is not the priority in managing a vaso-occlusive crisis.
B. Maintaining hydration through intravenous fluids is the priority as it helps to reduce blood viscosity and prevent further sickling of cells, which is critical in managing a vaso-occlusive crisis.
C. Active range-of-motion exercises are important but are not a priority during an acute vaso-occlusive crisis.
D. A protein-rich diet supports overall health but is not immediately relevant to the acute management of a vaso-occlusive crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E","F"]
Explanation
Given the client’s symptoms (right lower quadrant pain, nausea, fever) and elevated WBC count indicating a possible infection, the provider may prescribe IV antibiotics. This is especially important if there is a concern for appendicitis or another bacterial infection.
B. The client may need to be kept NPO (nil per oral) in preparation for possible surgery or diagnostic imaging to prevent complications such as aspiration if surgery is needed.
C. Promethazine is an antiemetic, but the priority in this case would be addressing the underlying condition (likely appendicitis) rather than just managing symptoms. However, it might be used later for symptomatic relief.
D. Acetaminophen may be used for pain management, but with a suspected surgical condition, addressing the root cause is more critical. Pain management will likely be considered after the primary issue is addressed.
E. With symptoms and lab results suggestive of appendicitis, the client may require surgery. Informed consent is necessary before any surgical procedure.
F. An abdominal ultrasound is commonly used to assess for appendicitis in children and can help confirm the diagnosis by visualizing the appendix and assessing for inflammation.
G. Enemas are not indicated in this case and could be harmful. They are not recommended for abdominal pain with a possible surgical condition like appendicitis.
Correct Answer is D
Explanation
A. Switching formula is not the first intervention, as projectile vomiting in an infant can indicate a more serious condition such as pyloric stenosis, which requires medical evaluation.
B. Oral rehydration solution may be needed if the infant is dehydrated, but the cause of vomiting must be assessed first.
C. While burping can reduce gas and discomfort, it is unlikely to resolve projectile vomiting, which may be due to a more serious underlying condition.
D. Bringing the baby to the clinic is the most appropriate action, as projectile vomiting can be a sign of pyloric stenosis or another serious condition that requires prompt medical attention.
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